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Sensitive, reliable and easy-performed laboratory monitoring of eculizumab therapy in atypical hemolytic uremic syndrome

Volokhina, Elena B.; van de Kar, Nicole C.A.J.; Bergseth, Grethe; van der Velden, Thea J.A.M.; Westra, Dineke; Wetzels, Jack F.M.; van den Heuvel, Lambertus P.; Mollnes, Tom Eirik
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/2384047
Date
2015
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  • Fakultet for medisin og helsevitenskap (uspesifisert) [490]
  • Publikasjoner fra CRIStin - NTNU [26591]
Original version
Clinical Immunology 2015, 160(2):237-243   10.1016/j.clim.2015.05.018
Abstract
Complement C5 inhibitor eculizumab treatment in atypical hemolytic uremic syndrome is effective, but associated

with high costs. Complement inhibition monitoring in these patients has not been standardized. In this

study we evaluated novel functional assays for application in routine follow-up.

We documented that the Wieslab® complement screen assay showed a sensitivity of 1–2% of C5 activity by

adding purified C5 or normal human serum to a C5 deficient serum. All the patient samples obtained during

the treatment course, were completely blocked for terminal complement pathway activity for up to four

weeks after the eculizumab infusion. Levels of complexes between eculizumab and C5were inversely correlated

to the complement activity (p=0.01).Moreover, titrating serumfromeculizumab-treated patients into normal

serum revealed that eculizumab was present in excess up to four weeks after infusion.

Thus, we demonstrate sensitive, reliable and easy-performed assays which can be used to design individual

eculizumab dosage regimens.
Publisher
Elsevier
Journal
Clinical Immunology

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